Nachsorge in der psychosomatischen Rehabilitation - Einfluss von Nachsorgegesprächen auf die sozialmedizinische Entwicklung und den Verlauf gesundheitsökonomischer Merkmale

Abstract

The aim of this study was to examine the influence of aftercare sessions in a psychosomatic rehabilitation on sociomedical development and health economic factors. The aftercare group was compared with treatment as usual. In a prospective, controlled and randomized longitudinal study. Data about the state of health, job status and health economic factors were assessed at four measured time points. As an indicator of the sociomedical development the current employment status was used. Health economic factors were also assessed (e.g. days off work, taking medications, utilization of hospitals or day-care facilities, contact rate to medical doctors or psychotherapists). Aftercare treatment (n = 139) included 2 - 4 interview contacts (via telephone or face-to-face) within the first three months after discharge from inpatient psychosomatic rehabilitation. A control group (n = 62) received treatment as usual. The acceptance of the aftercare treatment was examined in telephone interviews. Three and nine months after the end of rehabilitation participants in the aftercare showed a better sociomedical development than the participants in the control condition. A significant influence of aftercare on reducing health economic costs was not found. The participants evaluated the aftercare treatment as helpful and perceived it as a motivational support to adhere to the rehabilitation aims after discharge. However, a participation rate of 25 % was lower than expected. In comparison with a group of non-participants (n = 184) the participants were on average more motivated at the beginning of the rehabilitation, were discharged from rehabilitation with a higher number of mental diagnoses, were better educated, reported more often the feeling to be at the right place (in inpatient psychosomatic rehabilitation) and were rarely severely disabled.